Our dilemma is that we hate change and love it at the same time; what we really want is for things to remain the same but get better.

Transcription

1 Our dilemma is that we hate change and love it at the same time; what we really want is for things to remain the same but get better. Sydney J. Harris

2 A common but not so constructive response to pressing issues

3 Perhaps this is closer to it! HARM REDUCTION SERVICES

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5 Changing the Status Quo First step -acknowledge the problem. Second step acknowledge the problem is not going to go away S/He that will not apply new remedies must expect new evils; for time is the greatest innovator. Francis Bacon

6 Definition of Harm Reduction Harm Reduction refers to policies, programmes and practices that aim primarily to reduce the adverse health, social and economic consequences of the use of legal and illegal psychoactive drugs without necessarily reducing drug consumption. Harm reduction benefits people who use drugs, their families and the community.

7 The Goal of Harm Reduction is to help drug users survive drug abuse with as little damage as possible. At stake are the lives, the health and the future of those involved.

8 Purpose of Harm Reduction Interventions To handle the drug problem as well as drug users in a way that is compatible with the needs of every citizen living in : the drug using citizens as well as the others. The situation does not have to be perfect in absolute terms. It has to be acceptable for the citizens

9 Changing the Status Quo Gain commitment on the need for critical action among partners Harm Reduction and Low Threshold programs are a key part of any comprehensive strategy In Vancouver commitment to implementing low threshold programs as a first step was critical Lifeskills Centre, Contact Centre, Community Health Clinics later the Supervised Injection Site, Onsite and Supportive Housing plan

10 Human Development and Learning Conditions for learning that are non-negotiable: 1. Sense of belonging not one that is earned but is an entitlement 2. Once belonging attained - the opportunity to acquire one s own sense of personal competencies and skills 3. Self determination emerges

11 The Problem of Criminalization Criminalization of people who become addicted to illegal drugs crushes this sense of belonging is divisive them and us paradigm This is why Harm Reduction is so essential within a context of criminalization - Harm Reduction restores the opportunity to belong and be accepted as a person in the community

12 2 Thresholds of Access to Healthcare System Abstinence Contact with only 20% of active users High Threshold Services Medium Threshold Services Street Drug Scene

13 3 Increased Access to Healthcare System Abstinence Increase in Public Health Services In Prison Needle Exchange High Threshold Services Heroin Prescription 15% Medium Threshold Services Low Threshold Methadone Drop In Day Centres Safe Injection Sites Work Programs Youth Programs Outreach Supportive Housing 50% Mental Health Services Increase in Public Order Street Drug Scene

14 Drug Treatment and Specialized Services Street drug scene with limited access to healthcare

15 Fostering Public Discussion Senior community leadership support for this is essential Committed partnerships Delay in implementing services is denial of services There is a moral and ethical imperative to respond Goal of public discussion is to gain commitment towards action

16 Stages of Developing a Strategy Bring stakeholders together Create a leadership and organizational structure Identify key community partners Conduct needs assessment and inventory of services Develop locally driven harm reduction strategy Mobilize community to implement the strategy Monitor implementation and adjust if necessary Communicate results From Harm Reduction: A British Columbia Community Guide

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19 Moving Forward What works for your community? Integrated needle exchange in health care sites? Somewhere to go, something to eat and someone who gives a damn? Police support for engaging severely addicted group and supporting a site for these services? WISH What are the main obstacles to implementing harm reduction approaches Public attitudes, NIMBY, funding, partners? What to do!!!!!!!!!!!!!!!!

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21 Harm Reduction Programs Can Coexist with other Forms of Land Use VCH Core addiction services in community health centres needle exchange, methadone prescribing, Look at other jurisdictions eg., Bern, Switzerland, Edmonton, Toronto Do not attempt to reach consensus! Instead put in place mitigation strategies to address fears of community eg. Supportive housing, Injection site, needle exchange in community health centres Parlay broad public support for Harm reduction into firm direction towards implementation

22 Revitalize Community Leadership Create a vehicle that builds on the various committees and task forces that exist Invite new leadership to the table Identify and put pressure on the barriers to moving forward craft good communications plan Bring outside expertise in to bear on the problem and educate the public and pressure decision makers Work with a relentless NGO community pushing, pushing, pushing, pushing towards movement

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30 Consumption Room on 2 nd floor

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37 Addiction is a public health issue

38 Thank You Donald MacPherson